Case Studies

An NIH study of treatments for high blood pressure, called the ALLHAT trial, shows some of the strengths and limitations of comparative effectiveness research to improve patient care. More...

Recent Blog Posts

PIPC chairman delivers speech to specialty docs on importance of patient centered CER
July 6, 2010 |

Partnership to Improve Patient Care (PIPC) chairman, Tony Coelho, recently delivered a speech on patient centered comparative effectiveness research (CER) in front of fifty specialty doctors from around the country, among others, at the Alliance for Specialty Medicine’s (ASM) “Capitol Hill Advocacy Conference.” The conference took place just a day before the specialty doctors met w

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Tony Coelho's recent speech on patient centered CER
June 24, 2010 |

Below: PIPC Chairman Tony Coelho's recent speech on patient centered CER. The speech was delivered on Tuesday, June 22, 2010 at the Alliance for Specialty Medicine's “Capitol Hill Advocacy Conference,” in Washington, D.C.

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Lack of support for "evidence-based health care"— don't blame the patient
June 10, 2010 |

A new Health Affairs article concludes, based on focus groups and interviews, that "consumers will revolt if evidence-based efforts are perceived as rationing or as a way to deny them needed treatment."

You don't need to look any further than public reaction to the U.S. Preventive Service Task Force's updated recommendations on mammography screening to see the proof of this.
 
How should policy-makers react? Should they conclude that consumers, and even more so, patients, cannot be relied on to make evidence-based decisions, and therefore these decisions need to be made for them? Or should they conclude that evidence-based models of medical care and health delivery need to be carefully constructed so they have the trust and support of patients and consumers?

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Quality and Cost

Define CER as a tool to improve patient care, not as a tool for cost containment: CER has value in helping patients and providers make good decisions, but only if it answers the questions that matter to them. CER that starts with cost containment goal will not lead to studies that answer these questions, and likely will result in misapplication of findings in order to achieve cost-cutting objective. CER that begins with the goal of quality improvement can help everyone in health care make better decisions, and will ultimately lead to better health care value.

Provide information on clinical value and patient health outcomes, not cost-effectiveness assessment: Providing doctors with information about the effectiveness of new tests and treatments can help them make better treatment decisions for their patients. But if the Institute conducts cost-effectiveness research, it will end up putting a dollar value on human life based on average study results that ignore differences between patients. The Institute’s research should not include cost-effectiveness determinations, which would lead to a focus on cetralized judgments about which healthcare options should be available.